Feds recover record $4.3 billion in health care fraud funds last year

McClatchy Washington BureauFebruary 26, 2014 


Onaney Hernandez, right, a "navigator," presents information during a session at Orlando Public Library on the process for individuals to get health insurance, during the first day of the federal Health Care Exchange, Tuesday, October 1, 2013.


The Obama administration’s health care fraud efforts recovered a record $4.3 billion in taxpayer cash in fiscal year 2013, up from $4.2 billion in 2012.

And for every dollar spent investigating health care fraud and abuse in the last three years, the government recovered $8.10, the Obama administration reported Wednesday.

That’s the largest three-year average return on investment in the 17-year history of the federal Health Care Fraud and Abuse Control Program.

A joint project of the Department of Justice and the Department of Health and Human Services, the fraud and abuse program has returned nearly $26 million to the Medicare Trust Fund and the treasury since it was formed in 1997.

“With these extraordinary recoveries, and the record-high rate of return on investment we’ve achieved on our comprehensive health care fraud enforcement efforts, we’re sending a strong message to those who would take advantage of their fellow citizens, target vulnerable populations, and commit fraud on federal health care programs,” said Attorney General Eric Holder.

In fiscal year 2012, the Justice Department opened 1,013 new criminal fraud investigations, resulting in 718 people being convicted of health care fraud charges.

“We’ve cracked down on tens of thousands of health care providers suspected of Medicare fraud,” said HHS Secretary Kathleen Sebelius. “New enrollment screening techniques are proving effective in preventing high risk providers from getting into the system, and the new computer analytics system that detects and stops fraudulent billing before money ever goes out the door is accomplishing positive results – all of which are adding to savings for the Medicare Trust Fund.”

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